The eye can be thought of as similar to a camera, with two main parts, a lens and a film. The front surface of the eye is called the cornea, and may be thought of like the lens on a camera. There is a second lens within the eye called the crystalline lens, which may become cloudier as we age. The film layer lines the back wall of the eye and is called the retina.
The eye contains several different types of glands which function together to create healthy tears. Inflammation or blockage of these glands may cause our tears to become unhealthy. Unhealthy tears may be produced in inadequate quantities or may evaporate too quickly.
Learn About the Common Causes of Dry Eye
Blepharitis – Bacteria living where the eye lashes meet the eyelids may build up, and lead to the accumulation of inflammatory material within the lashes.
Meibomian Gland Dysfunction – The meibomian glands are located where the eye lashes meet the eyelids and produce a liquid oil. These glands may become blocked over time. Blockage of these glands causes tears to evaporate too quickly.
Medications – Diuretics used for the treatment of heart failure and high blood pressure may contribute to dry eye. Antihistamines used for allergies may also contribute to dry eye.
Inadequate production of tears – This condition is very uncommon. It is associated with inflammatory conditions (for which patients usually have other symptoms) such as Lupus, Sjogrens disease, and rheumatoid arthritis.
Dry Eye Treatments
Lid washes are very effective at removing lid debris from the eye lashes. Removing this debris decreases inflammation and leads to healthier tears.
This may be performed by using baby shampoo to create a lather, closing the eyes, and gently washing where the eye lashes meet the eye lids for 10-15 seconds. The baby shampoo is then washed away. Most patients will perform this on a daily basis.
The meibomiand glands may become clogged with oil that has transformed from a liquid into a solid. Warm compresses help melt the oil and allow it to enter the tear film.
This may be performed by placing a washrag in warm water, closing the eyes, and setting the washrag over the closed eye lids for 3-4 minutes. This is typically repeated nightly. This may alternatively be performed with an eye mask.
Artificial tears help to lubricate the surface of the eye. Lubrication of the surface of the eye improves vision and increases comfort. There are three main types of artificial tears: artificial tears with preservatives, preservative free artificial tears, viscous gels, tears for meibomian gland dysfunction, and lubricating eye ointment.
Artificial tears with preservatives are the larger bottles that you see at stores. They may be used up to 4 times daily as needed for discomfort for most patients. It is uncommon, but some patients may experience irritation from the preservative within the tears. They last for approximately 15 minutes.
Artificial tears without preservatives are sold in a pack with several small vials. They may be used up to every one hour as needed for discomfort. They last for approximately 15 minutes.
Viscous gels are made for people with more severe forms of dry eye. These gels have a consistency similar to syrup, and may cause some blurry vision for 15 minutes or so. The benefit of using them is that the lubricating effect may last upwards of an hour or more.
Artificial tears for meibomiand gland dysfunction – These artificial tears are made especially for people who are not producing the normal oil created by the meibomiand glands. This drops may help the tears last longer, lubricate the eyes more, and improve comfort. Please see the link below for recommended options.
Lubricating eye ointment – This is a thick savv which is placed between the eyelids and eye. It is typically used before sleep for patients who have severe dry eye, or who experience air from their CPAP blowing into their eyes at night. Ointment is very effective at lubricating the eyes, but will cause significant blurry vision, which may last hours. Many patients will also notice that it accumulates on the lashes and needs to be washed off in the morning.
The consumption of foods or supplements which are high in omega-3 increase the quality of the oil produced by the meibomian glands, and improves dry eye. Foods that are rich in Omega-3 include fish, flaxseeds, and walnuts.
There are high quality supplements, such as Pristine, which contain the ideal mixture of supplements required to optimize the tear film.
We recommend a diet high in omega 3s.